Panic attacks associated with topiramate.
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Adult↗
Biomedical subjects
Lionel Cailhol
Publications and source records attributed to Lionel Cailhol.
[Major depressive disorders and psychiatric emergencies: a naturalistic study on crisis intervention relevance].
OBJECTIVE: This retrospective study aimed to evaluate the impact of introducing crisis intervention patterns in the emergency unit of a general hospital on the number of admissions and outpatient follow-ups for patients with major depressive disorder. METHOD: The study included all patients with major depressive disorder (DSM-IV criteria) who visited the psychiatric emergency unit in a general hospital during two 8-month periods: before (425 patients) and after (436 patients) crisis interventions were introduced. RESULTS: After crisis interventions were introduced, the voluntary admission rate decreased significantly (from 17.9% to 12.4%), while the number of outpatient follow-ups increased (from 82.1% to 86.2%). Borderline personality disorder was associated with a significant reduction of the admission rate (27.8% against 38.2%), while the admission rate for patients with depressive disorder with psychotic features did not decline after crisis interventions. Crisis interventions were more effective on women. CONCLUSIONS: These outcomes suggest the relevance of crisis intervention in psychiatric emergency settings to improve the management of patients with major depressive disorder. Crisis intervention fosters outpatient multimodal follow-up rather than admission in a psychiatric setting.
Adult↗
Violent behavior of patients admitted in emergency following drug suicidal attempt: a specific staff educational crisis intervention.
OBJECTIVE: In spite of much effort to create guidelines on the management of violent behavior (VB) in emergency departments, little is known about the impact of such guidelines on a real-life emergency environment. The aim of this study is to investigate the impact of a staff educational crisis intervention (SECI) on the reduction of VB in patients admitted to emergency departments following drug suicidal attempt. METHOD: The impact of a SECI on VB of patient consulting the ER following a drug suicide attempt was assessed by comparing the occurrence of VB before (5 months) and after (5 months) the introduction of a SECI. RESULTS: A significant reduction in VB (from 17.32% to 7.14%) was found with the comparison of two 5-month periods: before (254 patients) and after (224 patients) the introduction of a SECI program (chi(2)=11.238; P=.0008). CONCLUSION: These preliminary data suggest the need for further prospective randomized studies aiming to prevent VB in emergency departments by developing specific SECI programs.
Crisis Intervention↗
Intramuscular olanzapine in patients with borderline personality disorder: an observational study in an emergency room.
OBJECTIVE: Despite the frequency of borderline personality disorder (BPD) in patients with acute agitation in emergency departments (EDs), there are few data about the use of intramuscular (IM) psychotropics in those patients. This is the first open-label study with olanzapine in this setting. METHOD: Measures were collected prospectively for patients with acute agitation in ED. Consent was obtained subsequently and diagnosis ascertained using the Structured Clinical Interview for DSM-IV. A group of 25 patients with severe agitation and BPD received olanzapine 10 mg IM. Efficacy and safety data are available at baseline, 2 h postinjection and at discharge. RESULTS: Significant reductions of agitation associated with good tolerance were observed 2 h after the first IM olanzapine. Sixteen percent of patients required a second IM olanzapine. CONCLUSIONS: Randomized, placebo-controlled studies are needed to confirm the efficacy of IM olanzapine in patients with acute agitation and BPD.
Adult↗